Coastal Diagnostics Inc

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

FAC 73365 Issued in CA

Legal business name

COASTAL DIAGNOSTICS INC

Practice address

9590 Chesapeake Dr
Suite 2
San Diego, CA 92123-1374

Phone

(619) 324-7333

NPI assigned

Apr 10, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul Francisco Romero Sr.

Title

Ceo

Phone

(619) 517-8205

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1306232806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9590 CHESAPEAKE DR",
            "address_2": "SUITE 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231374",
            "telephone_number": "619-324-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9590 CHESAPEAKE DR",
            "address_2": "SUITE 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231374",
            "telephone_number": "619-324-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "FRANCISCO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-517-8205",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "CA",
            "license": "FAC 73365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS ENTITY NUMBER",
            "identifier": "C3693543",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mobile Radiology Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Mobile Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.